Help with interpreting data?

[claireybear]

Hello wiser and more experienced users.... I am new to this CPAP thing, and have been using my machine for about a week now. I have an ResMed Elite II and have figured out how to access my data, but this has led to a few questions... my EPR is set at 3 and I have it set at "fast" which I assume means it reacts more quickly to the exhale.... all I know is that this has made it much more comfortable for me to breathe. My pressure is prescribed at 9 and the ramp was set to start at 4, but I turned that off because I found that wasn't enough pressure to breathe and not feel like I was suffocating. The doctor's office set me up with my equipment and offered me what I assume is their standard issue nasal pillow (I have an Opus 360 set up -- not an option on the ResMed mask setting so I have it set to "Standard"), which I took because I tend to side or tummy sleep. Here is my question:

Here is my data for the first week:
HI 9.2
AI 0.4
AHI 9.7
.14 L/s

Isn't it the apneas that really matter? I think my AHI was at 39 during my initial sleep study so this is obviously a huge improvement but I am wondering what additional tweaking I could do to get these numbers to improve even more --- or is this leak rate and AHI acceptable?

Things I have tried: switching from small to medium nasal pillows and back again (I cannot seem to find a comfy fit, the small almost hurts I have to pull it so tight and the medium seems to leak more easily -- I think I am between these two sizes), bumping up pressure to 10 or 11 to compensate for EPR (did not seem to change anything), taping my mouth.

What gives? Do I accept these numbers? Are they accurate even though my mask setting is at "Standard"? Do I ask to try a different mask? What have people's experiences been with different nasal pillows? I would like to find one that I can side or tummy sleep with without increasing my leak rate to a ridiculous amount.

I would really appreciate anyone's advice re: how to troubleshoot this info. I am a Psychology major in school (last final!) so I am of course data obsessed and really want to make these numbers as good as I can get them, I just need help knowing what to tweak.

[apnez]

Hi,

Get a USB connection or a card reader and the software.

[robertmarilyn]

Hello wiser and more experienced users.... I am new to this CPAP thing, and have been using my machine for about a week now. I have an ResMed Elite II and have figured out how to access my data, but this has led to a few questions... my EPR is set at 3 and I have it set at "fast" which I assume means it reacts more quickly to the exhale.... all I know is that this has made it much more comfortable for me to breathe.

I've noticed that fast/medium setting choice on my machine but haven't fiddled with it to know how much difference I would feel.

My pressure is prescribed at 9 and the ramp was set to start at 4, but I turned that off because I found that wasn't enough pressure to breathe and not feel like I was suffocating. The doctor's office set me up with my equipment and offered me what I assume is their standard issue nasal pillow (I have an Opus 360 set up), which I took because I tend to side or tummy sleep. Here is my question:
I have been noticing leak rates between .1something and .2something.... I can access data for the night immediately prior to the day I check it, but then it seems to disappear.

The daily data clears out at noon each day on our machines. So if you want to see the results of the night before on the LED screen, you need to look at them before noon.

I have almost no apneas at all (some nights have had none)

That's great!

but have several hypopneas a night and my AHI has been around the 7-9 range. Isn't it the apneas that really matter? I think my AHI was at 39 during my initial sleep study so this is obviously a huge improvement but I am wondering what additional tweaking I could do to get these numbers to improve even more --- or is this leak rate and AHI acceptable?

There are some expert numbers tweakers here that will be able to help you better than I can...and all the ins and outs of hypopneas and apneas...but with a ResMed machine...reports hypopneas more generously than other machines so you can take an HI number of, 7-9 and divide it by 2 for a HI of 3.5 to 4.5...with no apneas that would make an AHI of 3.5 - 4.5 which is pretty good...under 5 for AHI. I do think a huge number of hypopneas (which you don't seem to have), even if you didn't have any apneas, would be worth eliminating if possible because too long with 'limited breathing' probably isn't a good thing

Things I have tried: switching from small to medium nasal pillows and back again (I cannot seem to find a comfy fit, the small almost hurts I have to pull it so tight and the medium seems to leak more easily -- I think I am between these two sizes), bumping up pressure to 10 or 11 to compensate for EPR (did not seem to change anything), taping my mouth. What gives? Do I accept these numbers? Ask to try a different mask? What have people's experiences been with different nasal pillows? I would like to find one that I can side or tummy sleep with without increasing my leak rate to a ridiculous amount.

It never hurts to try a different mask. I've only had experience with 2 full face masks that didn't fit and two nasal masks, one that didn't fit and one that did, so I am no expert on masks...but even though I do get a good fit with my nasal mask, I plan to find a full face mask that fits me too...so I can use it if I am ever congested

I would really appreciate anyone's advice re: how to troubleshoot this info. I am a Psychology major in school (last final!) so I am of course data obsessed and really want to make these numbers as good as I can get them, I just need help knowing what to tweak.

If you get the software and reader you can do all kinds of data obsessing if that is your thing And really, you need the software and reader to get a true picture of what is going on.

[riverdreamer]

If you have only had your CPAP for a week, you have already made an awful lot of changes. It takes a little time for your body to adjust to the pressure. There is also a natural variation to how you do each night. Most of the experienced users here recommend making one change at a time, and then watching your data for a week or more.

Your leak rate is decent. If it gets to .40 or more, it is too much. You are right, most people do better without a ramp as low as 4. So that is fine. But changing the pressure, or changing the EPR pressure (probably not the speed, but maybe), or changing your mask, has enough impact to take some time to see the pattern of your response. It also takes time to heal from the stress your body has been under. Just being new to CPAP will show changes as your body accomodates to the pressure.

I would suggest you leave things alone for a week or more, and see how you do. Once you have the info from that time, you will know better what your range of response is. Then you can decide if you need to raise pressure, lower EPR, or, eventually, maybe both.

I agree with getting the software. It will give you more details on when the apneas and hypopneas occur, and whether they are related to leaks. Good luck!

[claireybear]

riverdreamer, i didn't even think about that. i suppose i have gotten quite overexcited. i will see what giving it some time does...

others: that download that you linked to, do i need other equipment to get the info off my card (a card reader? do i need a specific one? can i get that on cpap.com?)

also, i was given a card but can't for the life of me find on my machine where it goes. the instructions it came with said there may or may not be a slot on the machine for it. is mine supposed to have one? i know that's probably a stupid question

[RiverDave]

Clairey,

Yes, you need a copy of ReScan and a card reader to get the data off your machine. The slot of the data card is is on the back of the machine.

[track]

Just for your own reference....based on my experience your HI will be cut in fourth with remstar M series machine...but your AI might double. It doesn't mean you will be getting better or worse treatment....it just means from respironics machine stand point your AHI will most likely be below 5....which is considered acceptable treatment.
I used a resmed machine for 2 years and never could get the HI much below 5...with the remstar it is always below one. Your AI is great...so I wouldn't worry.